Table 2 Summary of main findings by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE)
Type of MW | Certainty assessment | Effect | ||||||
|---|---|---|---|---|---|---|---|---|
Number of studies | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | Absolute (95% CI) OR qualitative assessment | Certainty | |
CHX MW | Cariogenic bacteria— MW vs placebos 4 RCT (≤ 3 month) | seriousa | seriousb | not serious | seriousc | publication bias undetected | Colony count of MS was significantly reduced compared to placebos according to three studies [34, 48, 52] Colony count of MS was slightly reduced compared to placebo in a short time (significantly at 15 min) [40] | ⨁◯◯◯ Very low |
Cariogenic bacteria— MW vs blank controls 2 RCT (≤ 3 month) | very seriousd | seriousb | not serious | very seriouse | publication bias undetected | Colony count of MS was significantly reduced compared to blank control according to one study [53] Colony count of MS was significantly reduced compared to baseline according to one study [51] | ⨁◯◯◯ Very low | |
Total bacteria— MW vs blank controls 2 RCT (≤ 3 month) | seriousa | seriousb | not serious | very seriouse | publication bias undetected | Colony count of total bacteria were significantly reduced compared to placebos according to two studies [34, 43] | ⨁◯◯◯ Very low | |
GI—MW vs placebos 3 RCT (≤ 3 month) | not serious | seriousf | not serious | seriousc | publication bias undetected | ⨁⨁◯◯ Low | ||
GI—MW vs blank controls 6 RCT (≤ 3 month) | seriousg | seriousf | not serious | seriousc | publication bias undetected | WMD 0.54 lower (0.96 lower to 0.13 lower) [35, 39, 49, 53, 55, 58] | ⨁◯◯◯ Very low | |
PI—MW vs placebos 2 RCT (≤ 3 month) | seriousg | not serious | not serious | very seriouse | publication bias undetected | PI was significantly reduced compared to placebos according to two studies [20, 32] | ⨁◯◯◯ Very low | |
PI—MW vs blank controls 4 RCT (≤ 3 month) | seriousa | seriousf | not serious | seriousc | publication bias undetected | ⨁◯◯◯ Very low | ||
PD—MW vs placebos 2 RCT (≤ 3 month) | not serious | not serious | not serious | very seriouse | publication bias undetected | PD was significantly reduced except mid-lingual site compared to placebo [32]. The changes of PD were significantly higher compared to placebo [56] | ⨁⨁◯◯ Low | |
Herbal MW | Cariogenic bacteria— MW vs placebos 2 RCT (≤ 3 month) | very seriousd | seriousb | not serious | very seriouse | publication bias undetected | Colony count of MS was significantly reduced compared to placebo [52]. Colony count of MS was slightly reduced compared to placebo in a short time (significantly at 1 and 15 min) [40] | ⨁◯◯◯ Very low |
Cariogenic bacteria— MW vs blank controls 2 RCT (≤ 3 month) | seriousa | seriousb | not serious | very seriouse | publication bias undetected | Colony count of MS was significantly reduced compared to baseline [48]. Colony count of MS was insignificantly reduced compared to baseline [51] | ⨁◯◯◯ Very low | |
GI—MW vs blank controls 3 RCT (≤ 3 month) | not serious | not serious | not serious | seriousc | publication bias undetected | ⨁⨁⨁◯ Moderate | ||
Plaque related index— MW vs placebos 3 RCT (≤ 3 month) | not serious | serioush | not serious | seriousc | publication bias undetected | PI’ was significantly reduced compared to placebo [56] VPI was significantly reduced compared to placebo [41] PI was insignificantly reduced compared to placebo [19] | ⨁⨁◯◯ Low | |
Plaque related index— MW vs blank controls 8 RCT (≤ 3 month) | seriousa | serioush | not serious | seriousc | publication bias undetected | PI’ was significantly reduced compared to baseline [39] PI’’ was significantly reduced compared to baseline [48] PI’’ was significantly reduced compared to baseline [54] PI’’’ was significantly reduced compared to baseline [58] BBI was significantly reduced compared to baseline [40] BBPI was significantly reduced compared to blank control [47] TI was significantly reduced compared to baseline [45] The amount of dental plaque was significantly reduced compared to baseline [38] | ⨁◯◯◯ Very low | |
Gingival inflammation related index—MW vs placebos 3 RCT (≤ 3 month) | seriousg | seriousi | not serious | seriousc | publication bias undetected | GBI was significantly reduced compared to placebo [41] GBI’ was significantly reduced compared to placebo [56] BI was significantly reduced compared to placebo [40] | ⨁◯◯◯ Very low | |
Gingival inflammation related index—MW vs blank controls 3 RCT (≤ 3 month) | seriousa | seriousi | not serious | seriousc | publication bias undetected | CPI was significantly reduced compared to baseline [35] SBI was significantly reduced, while MGI was similar compared to baseline [45] BOP was significantly reduced compared to blank control [39] | ⨁◯◯◯ Very low | |
Fluoride MW | Cariogenic bacteria—MW vs blank controls 2 RCT (≤ 3 month) | seriousa | seriousb | not serious | very seriouse | publication bias undetected | Colony count of MS was significantly reduced compared to baseline according to two studies [33, 34] | ⨁◯◯◯ Very low |
Cariogenic bacteria—MW vs blank controls 2 RCT (≥ 12 month) | seriousa | seriousb | not serious | very seriouse | publication bias undetected | Colony count of MS was similar to blank control according to two studies [37, 59] | ⨁◯◯◯ Very low | |
Cariogenic bacteria—MW vs blank controls 2 RCT (≥ 12 month) | seriousa | seriousb | not serious | very seriouse | publication bias undetected | Colony count of LB was similar to blank control according to two studies [37, 59] | ⨁◯◯◯ Very low | |
Plaque related index— MW vs blank controls 2 RCT (≤ 3 month) | seriousa | serioush | not serious | very seriouse | publication bias undetected | TI was significantly reduced compared to baseline [34]. PI was significantly reduced compared to baseline, while similar with blank control [46] | ⨁◯◯◯ Very low | |
Plaque related index— MW vs blank controls 2 RCT (≥ 12 month) | seriousa | serioush | not serious | very seriouse | publication bias undetected | PI was similar to blank control [37] API was slightly reduced compared to blank control (significant at 6 and 9 months) [59] | ⨁◯◯◯ Very low | |
Gingival inflammation related index—MW vs blank controls 2 RCT (≤ 3 month) | seriousa | seriousi | not serious | very seriouse | publication bias undetected | MGI’ and BI’ was significantly reduced compared to baseline [34]. BOP and GI was slightly lower compared to blank control [46] | ⨁◯◯◯ Very low | |
CPC MW | Plaque related index— MW vs blank controls 3 RCT (≤ 3 month) | seriousa | serioush | not serious | seriousc | publication bias undetected | BBPI was significantly reduced compared to blank control [47] PI was significantly reduced compared to blank control [50] The amount of dental plaque was significantly reduced compared to baseline [38] | ⨁◯◯◯ Very low |
Probiotic MW | Cariogenic bacteria—MW vs blank controls 2 RCT (≤ 3 month) | seriousa | seriousb | not serious | very seriouse | publication bias undetected | Colony count of MS was significantly reduced compared to blank control [53]. Colony count of MS was insignificantly increased compared to baseline [33] | ⨁◯◯◯ Very low |